John H. Calhoon, M.D., professor of medicine, is founding chair of the new Department of Cardiothoracic Surgery. He holds the President's Council Chair in Surgery and the Tena C. Gorman Distinguished Chair in Pediatric Cardiac Surgery.
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By Will Sansom

The UT Health Science Center San Antonio entered a new era in cardiothoracic surgery this fall, with faces who have been on campus a long time and others who have been recruited in recent years. The School of Medicine elevated the Department of Cardiothoracic Surgery from a division on Sept. 1.

John H. Calhoon, M.D., who joined the faculty in 1989 and was appointed head of the division in 1996, is the founding chair. Edward Sako, M.D., Ph.D., who joined the faculty in 1992, is vice chair. The change to departmental status was announced by Francisco González-Scarano, M.D., dean of the School of Medicine and the university’s vice president for medical affairs.

Departmental leadership
The new department has three divisions:

• Ed Sako, M.D., Ph.D., is head of the Division of Adult Cardiac Surgery.
  
• Scott Johnson, M.D., is head of the Division of Thoracic Surgery. He joined the Health Science Center in 1995.
  
• S. Adil Husain, M.D., is head of the Division of Congenital Heart Surgery. He was recruited in 2008.

“Departmental status facilitates our interactions with cardiology, pediatrics and pulmonary medicine faculty members,” Dr. Calhoon said. “We now have improved ability to collaborate on research and clinically with the people who are most closely aligned with us in patient care.”

Luis Angel, M.D., and Deborah Levine, M.D., former division faculty, although maintaining joint appointments, are supported in the Department of Medicine’s Division of Pulmonary Medicine. “This realignment provides even more depth and coverage for our patients,” Dr. Calhoon said. “We have better physician and provider support for the lung transplant program than ever before.”

Dr. Angel remains a co-director of the lung transplant program with Dr. Johnson. David Abramson has been appointed the administrator for the department, and played a large role in its creation, along with the steadfast support and guidance from Ronald Stewart, M.D., and Michelle Price, Ph.D., M.Ed., from the Department of Surgery.

Research
On the research front, the department continues its studies of lung transplantation in rodents. The cardiothoracic research team is partnering with other groups in the Health Science Center to address lung inflammation and rejection, common problems in lung transplantation.

“What we hope to do is to make a focused investment as a department in scientists with expertise in pulmonary inflammation,” Dr. Calhoon said.

An expression of that commitment will hopefully soon be a formalized center with the Department of Microbiology & Immunology and the School of Medicine. “We hope to attract first-class researchers in that area,” Dr. Calhoon said. “This is an area of translational investment that should really benefit the area of lung transplantation and, specifically, the patients of our region and our institution.”

He added, “This idea of having a lab to look at inflammation will spill over into heart ischemia and reperfusion injury. Every time you operate on a heart, you have to stop it, deprive it of a blood supply and restart it.”

In the Division of Congenital Heart Surgery, meanwhile, faculty are particularly interested in patient outcomes, with research dedicated to improving clinical outcomes and care.

Collaboration in cardiology and pulmonary medicine
Some of the best cardiothoracic surgery programs in the country are realigning themselves more closely with pulmonary medicine and cardiology, Dr. Calhoon said. Creating a department allows cardiothoracic surgery to align its resources more easily into areas of shared interest with cardiology and pulmonary medicine as well as those interests shared with basic scientists.

Recently, on a national scale, cardiothoracic surgery profession has created independent, integrated residency training programs. (The requirement for general surgical education as a precursor has been removed). Similarly, the American Board of Thoracic Surgery now outlines a clear and distinct curriculum. “Thus, our program recently developed a training paradigm for medical residents right out of medical school,” Dr. Calhoon said. “Training residents to become heart and lung surgeons is both labor- and time-intensive, and this new integrated approach allows for the kind of deliberate practice of the fine motor and other technical and problem-solving skills we wish our residents to master.”

A.J. Carpenter, M.D., Ph.D., is the residency program simulation director, with Seenu Reddy, M.D., M.B.A., as the associate program director.

The Department of Cardiothoracic Surgery now has approximately 40 persons, including 12 physicians and a diverse and dedicated group of nurses, midlevel providers, perfusionists, researchers, residents and administrative staff.

“I am very pleased with our team,” Dr. Calhoon said. “It is a pleasure, and humbling, to work with such a good group of people.”